| NPI | 1396869970 |
|---|---|
| Doing Business As | LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | KERRY E. WEINER President 818-637-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2009-05-11 |